Food-induced anaphylaxis in infants, as compared to toddlers and preschool children in Turkey


KAHVECİ M. , AKARSU A. , Koken G. , ŞAHİNER Ü. M. , Soyer Ö. , ŞEKEREL B. E.

PEDIATRIC ALLERGY AND IMMUNOLOGY, 2020 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası:
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1111/pai.13320
  • Dergi Adı: PEDIATRIC ALLERGY AND IMMUNOLOGY

Özet

Background The literature includes scarce data on infants with food-induced anaphylaxis (FIA). Materials and Methods Medical records of the patients diagnosed with FIA aged 0-6 years between 2015 and 2020 were retrospectively analyzed. Results During the study period, there were 451 instances of FIA in 314 patients, of which 175 (38.8%) occurred in 160 infants (50.9%). The median (IQR) age of infants was 7 months (6-9 months) with a male predominance (67.5%), of which 7.5% had multiple instances (>= 2) and 60% atopic dermatitis. The most common triggers were cow's milk (51.4%), tree nuts (16.6%), and hen's egg (15.4%), whereas tree nut was the most common trigger in toddlers (35.8%) and preschool children (35.2%). Skin and neurologic symptoms, and nausea-vomiting occurred more frequently (P = .003,P <= .001, andP = .003, respectively), whereas respiratory symptoms occurred less commonly in infants compared to toddlers and preschool children (P <= .001). In infants, 65 (37.1%) mild, 92 (52.6 %) moderate, and 18 (10.3%) severe episodes of anaphylaxis were detected. History of recurrent wheezing (OR: 6.837 [95% CI: 1.940-24.097],P = .003) and tree nut allergy (OR: 2.849 [95% CI: 1.056-7.688],P = .039) were found to be independent risk factors for moderate-to-severe anaphylactic reactions. 40.6% of the infants received adrenaline, which was lower than the toddlers (49.7%) and preschool children (57.6%) (P = .005). Conclusion There is no doubt that food-induced anaphylaxis is a medical emergency, specifically in young children. Pediatricians should be aware of the distinct features of infant anaphylaxis, particularly gastrointestinal and neurologic symptoms to provide effective treatment as soon as possible.